Hutch Clinic still tied to contractors despite letter

By Mike Shields Special to The News

Tuesday

Jan 28, 2014 at 12:01 AM

Citing "numerous difficulties" getting paid correctly, one of the state's largest doctor groups sent a letter to its Medicaid patients telling them it might drop its contracts with two of the state's three KanCare managed care companies.

The letter, sent last month by the Hutchinson Clinic, sparked concern among patients and downstream service providers who said the letter left them wondering what they could or should do now that KanCare open enrollment is upon them.

The letter was interpreted by many who received it as an attempt to steer the clinic's patients to Sunflower State Health Plan and away from the other two KanCare contractors - Amerigroup and UnitedHealthcare. But Michael Harms, the Hutchinson Clinic's chief financial officer, said the clinic will continue contracting with all three companies through 2014. "We are working on communication (of this decision) with patients," he said in an email Tuesday.

Kari Bruffett, director of the division of health care finance at the Kansas Department of Health and Environment, wrote in an email that KDHE officials had been in touch with the Hutchinson Clinic about the letter.

"We are committed to ensuring KanCare members have access to health services," she said. "We have continued to gather information on the issues raised related to the Hutchinson Clinic, with a focus on any effect on members. We have spoken to the clinic and have been assured that its physicians will continue to see KanCare members, regardless of the MCO with whom the member is enrolled."

"Steering" is a practice barred and penalized in some states that have Medicaid managed care plans and is considered counter to federal rules intended to promote plan choice for Medicaid beneficiaries. One Kansas legislator suggested similar rules might be needed in Kansas in light of the letter.

"Our Medicaid recipients were promised choice when KanCare was launched. Any attempts to narrow or eliminate that choice by either providers or the managed care companies should not be tolerated. If it takes legislation or regulation to ensure choice, so be it," said Sen. Laura Kelly, a Topeka Democrat.

Sunflower State Health Plan officials said they had no knowledge of the letter before it was sent by the clinic and neither condoned nor endorsed it. "We really had nothing to do with them (the clinic) sending it out," said Monica Stoneking, Sunflower communications director.

Harms said the letter was sent without consulting any state or managed care company officials but reflected the frustration clinic officials have been experiencing since KanCare was launched Jan. 1, 2013. Harms said the clinic has had problems with "thousands of claims" it has filed with the KanCare companies and is behind "hundreds of thousands" of dollars in payments due from them.

"It's been frustrating for us," Harms wrote in an email, "because everyone wants to talk about the problems and (there is) no action. How about let's set some hard deadlines for resolution of claims issues instead of letting the MCO companies drive the resolution of these claims problems on their terms. Let's get the problems fixed."

Harms said between 5 and 10 percent of the clinic's patients are enrolled in a KanCare health plan. Included among them are clients of TECH, Inc., the nonprofit umbrella organization for the Reno County Community Developmental Disability Organization.

Brenda Maxey, TECH's chief executive, said the letter had created consternation among many of the 250 clients the organization serves that are on KanCare, most of whom are developmentally disabled. Maxey said the organization had built a "matrix" that mapped which area health care providers were aligned with which KanCare companies and what services each TECH client could receive.